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- Title
Neurobehavioral outcomes in preterm, growth-restricted infants with and without prenatal advanced signs of brain-sparing.
- Authors
Figueras, F.; Cruz-Martinez, R.; Sanz-Cortes, M.; Arranz, A.; Illa, M.; Botet, F.; Costas-Moragas, C.; Gratacos, E.
- Abstract
Objective To evaluate the neurobehavioral outcomes of preterm infants with intrauterine growth restriction (IUGR), with and without prenatal advanced brain-sparing. Methods A cohort of IUGR infants (birth weight < 10th percentile with abnormal umbilical artery Doppler) born before 34 weeks of gestation was compared with a control group of appropriate-for-gestational age infants matched for gestational age at delivery. MCA pulsatility index was determined in all cases within 72 hours before delivery. Neonatal neurobehavior was evaluated at 40 weeks' ( ± 1) corrected age using the Neonatal Behavioral Assessment Scale. The effect of abnormal MCA pulsatility index (< 5th percentile) on each neurobehavioral area was adjusted for maternal smoking status and socioeconomic level, mode of delivery, gestational age at delivery, pre-eclampsia, newborn illness severity score and infant sex by multiple linear and logistic regression. Results A total of 126 preterm newborns (64 controls and 62 IUGR) were included. Among IUGR fetuses, the proportion of abnormal MCA Doppler parameters was 53%. Compared with appropriate-for-gestational age infants, newborns in the IUGR subgroup with abnormal MCA Doppler had significantly lower neurobehavioral scores in the areas of habituation, motor system, social-interactive and attention. Similarly, the proportion of infants with abnormal neurobehavioral scores was significantly higher in the IUGR subgroup with abnormal MCA Doppler parameters in the areas of habituation, social-interactive, motor system and attention. Conclusion Abnormal MCA Doppler findings are predictive of neurobehavioral impairment among preterm newborns with IUGR, which suggests that this reflects an advanced stage of brain injury with a higher risk of abnormal neurological maturation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
- Subjects
PREMATURE infant physiology; FETAL growth retardation; NEUROBEHAVIORAL disorders; GESTATIONAL age; UMBILICAL arteries; BRAZELTON Neonatal Behavioral Assessment Scale
- Publication
Ultrasound in Obstetrics & Gynecology, 2011, Vol 38, Issue 3, p288
- ISSN
0960-7692
- Publication type
Article
- DOI
10.1002/uog.9041